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r✓2olS <br />City of Santa . la ✓ <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM FOTC office Use Only <br />Please complete this form when the attached agreement and all <br />4i 6 i F IS 1,61, H, Ids F 64 A <br />amendments (if any) are no longer in effect. ME' K OFF <br />Return form to the Clerk of the Council Office (M -30). <br />Call 647 -6520 if you have any questions. <br />The agreement with �dr1�t `�"uY J- - (y, <br />No. <br />" � � � -on was completed on l/W f ! -W and final payment has been made. <br />(List all amendments. Use space below if needed.) � <br />Department: 1�°j ° <br />Phone /Ext.: <br />Signature: <br />Date: Ii7r J <br />Revised 08 -23 -10 <br />